Journal of Community Health

, Volume 40, Issue 6, pp 1178–1184 | Cite as

Effect of Educational Intervention on Cervical Cancer Prevention and Screening in Hispanic Women

  • Olivia W. Foley
  • Nicole Birrer
  • J. Alejandro Rauh-Hain
  • Rachel M. Clark
  • Elizabeth DiTavi
  • Marcela G. del Carmen
Original Paper


To evaluate the effect of an educational intervention on four domains of health care utilization and cervical cancer prevention and screening in a Hispanic population. Data collected from a survey were used to design education strategies focused on four domains of interest. A second survey was conducted to measure the impact of the intervention. Following the intervention, respondents were more likely to have any knowledge of human papillomavirus (HPV). Respondents living in the United States (US) for <5 years were more likely to have had a Papanicolaou smear in the preceding 3 years (p = 0.0314), to report knowledge of HPV vaccination (p = 0.0258), and to be willing to vaccinate themselves (p = 0.0124) and their children (p = 0.0341) after the intervention. Educational interventions designed to meet the needs identified by the sample group led to an increase in HPV awareness throughout the entire population surveyed and an increase in health care service utilization and HPV vaccine acceptance for women living in the US for <5 years. These tools should be promoted to reduce the cervical cancer burden on vulnerable populations.


Cervical cancer HPV Prevention Education Screening 



This work was funded by Massachusetts General Hospital Clinician-Teacher Development Award and the Deborah Kelly Center for Outcomes Research Award.

Conflict of interest

The authors report no conflicts of interest.


  1. 1.
    Peterson, N. B., Han, J., & Freund, K. M. (2003). Inadequate follow-up for abnormal Pap smears in an urban population. Journal of the National Medical Association, 95, 825–832.PubMedCentralPubMedGoogle Scholar
  2. 2.
    Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics for Hispanics/Latinos. CA: A Cancer Journal for Clinicians, 62, 283–298.Google Scholar
  3. 3.
    Watts, L., Joseph, N., Velazquez, A., Gonzalez, M., Munro, E., Muzikansky, A., et al. (2009). Understanding barriers to cervical cancer screening among Hispanic women. American Journal of Obstetrics and Gynecology, 201, e1–e9.CrossRefPubMedGoogle Scholar
  4. 4.
    Bosch, F. X., Lorincz, A., Muñoz, N., Meijer, C. J. L. M., & Shah, K. V. (2002). The causal relation between human papillomavirus and cervical cancer. Journal of Clinical Pathology, 55, 244–265.PubMedCentralCrossRefPubMedGoogle Scholar
  5. 5.
    Rubin, D. B., & Schenker, N. (1991). Multiple imputation in health-care databases: An overview and some applications. Statistics in Medicine, 10, 585–598.CrossRefPubMedGoogle Scholar
  6. 6.
    Fletcher, A. (1990). Screening for cancer of the cervix in elderly women. Lancet, 335, 97.CrossRefPubMedGoogle Scholar
  7. 7.
    Fahs, M. C., Mandelblatt, J., Schechter, C., & Muller, C. (1992). Cost effectiveness of cervical cancer screening for the elderly. Annals of Internal Medicine, 117, 520.CrossRefPubMedGoogle Scholar
  8. 8.
    Schafer, J. L. (1999). Multiple imputation: A primer. Statistical Methods in Medical Research, 8, 3–15.CrossRefPubMedGoogle Scholar
  9. 9.
    Watts, L. A., Joseph, N., Wallace, M., Rauh-Hain, J. A., Muzikansky, A., Growdon, W. B., et al. (2009). HPV vaccine: A comparison of attitudes and behavioral perspectives between Latino and non-Latino women. Gynecologic Oncology, 112, 577–582.CrossRefPubMedGoogle Scholar
  10. 10.
    Patel, D. A., Zochowski, M., Peterman, S., Dempsey, A. F., Ernst, S., & Dalton, V. K. (2012). Human papillomavirus vaccine intent and uptake among female college students. Journal of American College Health, 60, 151–161.PubMedCentralCrossRefPubMedGoogle Scholar
  11. 11.
    Allen, J. D., Othus, M. K., Shelton, R. C., Li, Y., Norman, N., Tom, L. S., et al. (2010). Parental decisions about the HPV vaccine. Cancer Epidemiology Biomarkers and Prevention, 19, 2187–2198.CrossRefGoogle Scholar
  12. 12.
    Taylor, L. S. H., Hariri, S., Sternberg, M., Dunne, E. F., & Markowitz, L. E. (2011). Human papillomavirus vaccine coverage in the United States. National Health and Nutrition Examination Survey, 2007–2008. Preventive Medicine, 52, 398–400.CrossRefPubMedGoogle Scholar
  13. 13.
    Centers for Disease Control and Prevention. (2013). Noninfluenza vaccination coverage among adults—United States, 2011. Morbidity and mortality weekly report, 62.Google Scholar
  14. 14.
    Krawczyk, A., Lau, E., Perez, S., Delisle, V., Amsel, R., & Rosberger, Z. (2012). How to inform: Comparing written and video education interventions to increase human papillomavirus knowledge and vaccination intentions in young adults. Journal of American College Health, 60, 316–322.CrossRefPubMedGoogle Scholar
  15. 15.
    Kahn, J. A., Rosenthal, S. K., Jin, Y., Huang, B., Namakydoust, A., & Zimet, G. D. (2008). Rates of human papillomavirus vaccination, attitudes about vaccination, and human papillomavirus prevalence in young women. Obstetrics and Gynecology, 111, 1103–1110.CrossRefPubMedGoogle Scholar
  16. 16.
    Manhart, L. E., Burgess-Hull, A. J., Fleming, C. H., Bailey, J. A., Haggerty, K. P., & Catalano, R. F. (2011). HPV vaccination among a community sample of young adult women. Vaccine, 29, 5238–5244.PubMedCentralCrossRefPubMedGoogle Scholar
  17. 17.
    Holcomb, B., Bailey, J. M., Crawford, K., & Ruffin, M. T. (2004). Adults’ knowledge and behaviors related to human papillomavirus infection. Journal of the American Board of Family Practice, 17, 26–31.CrossRefPubMedGoogle Scholar
  18. 18.
    Jain, N., Euler, G. L., Shefer, A., Lu, P., Yankey, D., & Markowitz, L. (2009). Human papillomavirus (HPV) awareness and vaccination initiation among women in the United States, National Immunization Survey-Adult 2007. Preventive Medicine, 48, 426–431.CrossRefPubMedGoogle Scholar
  19. 19.
    Gerend, M. A., & Magloire, Z. F. (2008). Awareness, knowledge, and beliefs about human papillomavirus in a racially diverse sample of young adults. Journal of Adolescent Health, 42, 237–242.CrossRefPubMedGoogle Scholar
  20. 20.
    Joseph, N. P., Clark, J. A., Bauchner, H., Wash, J. P., Mercilus, G., Figaro, J., et al. (2012). Knowledge, attitudes, and beliefs regarding HPV vaccination: Ethnic and cultural differences between African-American and Haitian immigrant women. Women’s Health Issues, 22, e571–e579.CrossRefPubMedGoogle Scholar
  21. 21.
    Akers, A. Y., Newmann, S. J., & Smoth, S. K. (2007). Factors underlying disparities in cervical cancer incidence, screening, and treatment in the United States. Current Problems in Cancer, 31, 157–181.CrossRefPubMedGoogle Scholar
  22. 22.
    Engelstad, L. P., Stewart, S. L., Nguyen, B. H., Bedeian, K. L., Rubin, M. M., Pasick, R. J., et al. (2001). Abnormal Papanicolaou smear follow-up in a high-risk population. Cancer Epidemiology Biomarkers and Prevention, 2001(10), 1015–1020.Google Scholar
  23. 23.
    Newmann, S. J., & Garner, E. O. (2005). Social inequities along the cervical cancer continuum: A structured review. Cancer Causes and Control, 16, 63–70.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Olivia W. Foley
    • 1
  • Nicole Birrer
    • 1
  • J. Alejandro Rauh-Hain
    • 1
  • Rachel M. Clark
    • 1
  • Elizabeth DiTavi
    • 1
  • Marcela G. del Carmen
    • 1
  1. 1.Division of Gynecologic Oncology, Vincent Obstetrics and GynecologyMassachusetts General HospitalBostonUSA

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